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Walk the evidence base by book and chapter — the raw source passages that ground Ask, Differential, and the rest.
1 passage
Central or Peripheral Precocious Puberty: Diagnostic Difficulties. BACKGROUND: An underlying identifiable organic cause is present in up to 50% cases of central precocious puberty in male patients. CASE CHARACTERISTICS: A 7-years-8-months-old presented with delayed puberal development. Analytical examinations showed suppressed basal and stimulated levels of testosterone, LH and FSH. Abdominal ultrasound and contrast cranial magnetic resonance results were initially negative. OUTCOME: Germinoma was found on cranial computer tomography. CONCLUSION: There is often a wide time-lapse between symptoms and diagnosis of germinoma, so frequent monitoring is vital.